A Modified Design External Fixator System for Calcaneal Fractures: Surgical Technique and an Observational...

Area of Science:

• Orthopedic Surgery
• Trauma Surgery
• Skeletal Reconstruction

Background:

• Displaced intra-articular calcaneal fractures present complex treatment challenges due to intricate anatomy and high risk of soft-tissue complications.
• Open reduction and internal fixation (ORIF) offers anatomical accuracy but carries significant wound morbidity.
• Minimally invasive techniques are explored to reduce complications associated with calcaneal fracture treatment.

Purpose of the Study:

• To describe a modified external fixation technique for displaced intra-articular calcaneal fractures.
• To evaluate the clinical and radiographic outcomes of this technique in a consecutive case series.
• To assess complication rates and functional recovery with a minimum one-year follow-up.

Main Methods:

• A modified external fixation technique was applied to 17 patients with displaced intra-articular calcaneal fractures.
• Surgical intervention was performed at a mean of 3 days post-injury.
• Radiographic parameters (Böhler's angle, time to union) and clinical outcomes (AOFAS, SF-12 P scores) were analyzed.

Main Results:

• Calcaneal morphology was restored post-operatively, with a mean Böhler angle increase to 27.8° at 12 months.
• All fractures achieved radiographic union, and functional scores improved significantly over time.
• A single complication (K-wire displacement) occurred in a psychiatric patient, necessitating conversion to ORIF.

Conclusions:

• The modified external fixation technique allows for early surgical intervention and satisfactory restoration of calcaneal anatomy.
• The technique demonstrates safety and efficacy in selected patients, with no soft-tissue complications reported.
• Further long-term follow-up is warranted to evaluate outcomes such as subtalar osteoarthritis.